Like you Paul, I had a deep tissue massage 2 weeks before the GNR last year. I am convinced this session caused me to have to withdraw from the race.

The deep massage was for ITB problems. It was incredibly painful. The physio did it and used his hands and elbows. About 24hrs later I came out in HUGE bruises- so much so, that I went back to the clinic to check this was "normal". I was told "yes"- that some people do bruise. I have never had such a painful massage before. The bruising was very painful. Advice from Physio was to run the GNR- as I wouldn't do myself any damage. I decided I did not want to run 13.1m and be able to "feel" every stride.

My experience of sports massage is a bit different, and much more positive. In response to the last question in the OP I had a massage 10 days before VLM and that was fine (and would have done it the Monday before if I hadn't been able to get the earlier appointment).

BUT: I'd been having reasonably regular massage (every 2 to 3 weeks) in the run-up to the race so I was used to it and knew how long it takes me to recover. And also I always have the same masseur, someone I know and trust. I think the main thing to avoid is trying anything new close to the race unless you absolutely have to. Bambi, would you have been able to run with the ITB problems?

I used to have fairly regular sports massages and the therapist , who is also a qualified osteopath so knows her stuff, would make sure she did not go in too deep in any session a week before an event.

1) The problem was too major to be fixed in one session. The runner should have got treatment earlier before the problem got to the stage that it did. The physio then tried to perform a miracle and get someone race fit who probably shouldn't have been running anyway.

Possible causes:

a) Runner was trying to save money by not getting treatment soonerb) Runner is fairly new to running and hasn't learnt to listen to their body and cannot yet tell when a niggle can be left and when it should be treatedc) Runner put a lot of pressure on the physio to fix the problem in one session and the physio responded to this by using a deeper treatment than he should have - Runner shouldn't have put the pressure on and physio should have known better than to allow himself to respond to that pressure

2) The physio was a bad egg (probably either inexperienced or arogant). A good physio should listen to their client and if there is a race coming up then they should perform a lighter treatment. If a lighter treatment won't solve the problem then the runner should have been advised not to run. Whether the runner choses to listen to that advice is outside the physio's control. A deeper treatment may have been the most approriate course of action if the runner wasn't running their 'A' race that weekend

Other possible lessons to take away from this:

Runners need to look after their bodies. Stretching, mobility exercises, strengthening exercises etc are the most important things you can do to look after yourself. If you listen to your body properly then you should rarely need to visit a physio. Most experienced runners will tell you that the primary reason for visiting a physio is because they tried to push their bodies too far and ignored the warning signs

You can treat a lot of injuries and niggles yourself through use of the foam roller or self massage. Take rest days when you need to and treat at the first signs of a problem. Get this right and you can avoid the physio

Some physios are better than others. If you can, find one who does a sport themselves as they will have the same mentality as you and are more likely to be honest about what you are capable of. My physio always gave me two options: Her recommended way of getting me back to running as soon as possible, and the route I could take if I was adament that I was racing that weekend. It was then up to me which treatment she did and it was my own fault if I chose the option that put me back a few weeks in the long term.

In all of the above I have used the term physio to mean a physio treatment or a sports massage.

You can bruise after treatment but it shouldn't be the norm. Reasons for bruising:

Serious injury that will get slightly worse before getting better. These are the sort of injuries where you can't put any weight on a leg for example. You know you have them and there is no way you can pretend that it is a niggle. Bruising should only occur on the first treatment

Runner tends to bruise easily at the best of times. If you know this to be the case with you then tell the physio as they may chose a different form of treatment. Physios don't intend to bruise you as it is often counter productive to the long term healing process.

Runner has an extremely high pain threshold (this is my problem) and can tolerate a very deep massage without flinching or tensing up. Physio may not realise how deep they are going without feedback from the runner.

Oh I love my sports masseuse and i would recommend her to anyone, but she is there when I can't sort the problem out myself. She is part of the team that includes my coach, support crew and training partners. I use all of them to get me race fit, but at the end of the day the responsibility for my fitness is down to me and I can't expect any of my team to make up for failings on my part.

SuperCaz - me too: my masseur has taught me loads of useful stuff. He always explains what's gone wrong if anything has (usually some sort of muscle tightness that could have been avoided with the right stretches, which he shows me), so I don't usually need him for the same problems again. I see it as a way of learning more about how to keep myself in good shape rather than a quick fix.

DF3 I take your point re the body fixing itself but speaking for myself I have had regular sports massages in the past because I've been training quite hard and it has been very beneficial. I went to a person I know and trust and it was fine. If you're actually "training" for an event, you might not have the time to just rest

the rule of thumb for me is to go to an older practitioner. Experience is very important, also a guy with no mortgage and a good pension doesn't need to milk you like a newly qualified Joey in a big mult-practice does.

DF3, I've used the advice to pay more attention to my body and how it feels. I'm not convinced there could be a double blind scientific study for what happened to be wrong with me at any particular time, because the sample would always have just been me!

But for example, when the masseur told me my left achilles pain was caused by tight glutes, he explained this by (a) pointing out that my achilles was not swollen and that manipulating it didn't hurt me, so that wasn't the source of the injury and (b) doing some really quite painful glute manipulations that hurt like hell on the side that was injured but not really at all on the other side. I was then able to run with no pain at all. And yes, it could have been a coincidence, but I had already tried icing, resting and stretching my calves (what google suggested) with no effect. Finally, because I am now more aware of the glute tightness issue, I pay more attention to it and now notice when it starts tightening up. And I've been taught more effective stretches to prevent the problem recurring.

It doesn't seem that implausible to me that someone trained in anatomy with more knowledge of how different muscles affect each other than I have, and who has actually examined my body, would be able to work out what was wrong and what to do about it more effectively than me googling it.

The internet is a fantastic source of information but the real benefit I get from seeing someone is from showing me how to do stretches properly and getting feedback on what I am doing right.

For example, I've been swimming all my life. A few years ago I did an event that challenged me and the following day my muscles were so sore that I couldn't do my bra up or put a seatbelt on in the car. This is despite doing all the right training, having proper nutrition, doing my stretches and structured recovery

Friday I did a tougher event but with preparation probably not quite as good as for the previous swim. This time I ache a little but not enough to stop me doing anything. The main difference between the two: I have been shown how the stretches I used to do were not providing me with any benefit because I didn't understand which muscles they were supposed to be working so was doing them wrong. Some tiny tweaks from my masseuse and my stretches are now working for me.

I know that isn't a double blind study either and I have only mentioned two events which on their own could be considered coincidence. But I know what works for me.

So my advice would be to use the internet but to supplement it with hands on practical advice from someone who knows what they are talking about. It doesn't have to be a physio if you have access to a good coach or someone with real knowledge and experience

Hard to find *quality* evidence based studies due to multiple variants. Sham massage vs sports? Double blinding isnt possible either. As soon as you put your hands on someone you're having an effect.. Be it good or bad. Placebo Nocebo.

I treat musculoskeletal injuries with massage, and other modalities depending on the injury. Soft tissue work i.e myofascial release, deep tissue and dry needling in that order of combination seems the most effective on feedback from my patients. I have new people and regulars; if what I did was ineffective, and I don't give a stuff if its placebo as long as they improve, then I would have no repeat patients or recommendations.

Brusing only occurs if I do frictions as you have to press hard, and its a small area so just a fingerprint size bruise. I warn patients. If doing deep tissue I go to patient tolerance level and not beyond. Regular feedback from therapist and patient. Had a patient who went for a Tai massage, and the therapist sprung his rib! Check they're qualified to degree level.

My experiences are *some* patients want a quick fix from me, with no input from themsleves.. not going to happen! They create the damage but wont listen to advice re cross training, rehab / stretches / strengthening to correct muscle imbalances etc, then whinge when their ITBS or muscle tear isnt mircaulously cured. I only treat 4 things: inflammation, inflexibility, imbalance, weakness.

If you don't like the therapist, don't go back. Simple! I don't have that option - ethics means I have to treat nice people and eejits. Just don't come running to me when you've broken your leg!

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